Diagnosis of multiple tuberculous muscle abscesses in a patient with systemic lupus erythematosus by metagenomic next-generation sequencing- a case report and literature review.

BACKGROUND: Early diagnosis of muscular tuberculosis (TB) without coexistent active skeletal involvement is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of muscular TB, we present a case of multiple tuberculous muscle abscesses in a systemic lupus erythematosus (SLE) female, but without pulmonary tuberculosis (PTB), in order to increase awareness of and stress the need of early detection of muscular TB. CASE PRESENTATION: A 44-year-old woman with a 6-year history of SLE who had been treated with methylprednisolone for a long time complained of erythema on her trunk and extremities for five months, along with edema and myalgia for two months, and fever for one month. The patient was first misdiagnosed as SLE overlap dermatomyositis. However, an ultrasound-guided drainage of muscle abscesses revealed positive acid-fast staining combined with positive deoxyribonucleic acid fragment of Mycobacterium tuberculosis using metagenomic next-generation sequencing (mNGS). The patient was cured and released following standard anti-tuberculosis medication, local puncture drainage, and an intravitreal injection of streptomycin. Literature search found only 19 cases of tuberculous muscle abscesses occurring in the extremities reported from 1999 to 2023. CONCLUSIONS: Extrapulmonary TB with predominantly muscle involvement is rare and with no specific clinical presentation. Muscular tuberculosis may be disdiagnosed for dermatomyositis due to the high muscle enzyme levels, delaying diagnosis and treatment. mNGS technology is helpful in the early and rapid diagnosis of muscular TB. On the basis of traditional anti-tuberculosis treatment, an ultrasound-guided percutaneous puncture drainage and intracavitary injection of streptomycin for the treatment of tuberculous muscle abscess is easy to operate, safe and effective, which is worthy of clinical popularization and application.

Comparison of 3D-printed Titanium Alloy and Polyether Ether Ketone Prosthetic Beaks for an Injured Red-crowned Crane (Grus japonensis).

The red-crowned crane (Grus japonensis) is a critically endangered species. Three-dimensional-printed prosthetic beaks made of titanium alloy and polyether ether ketone (PEEK) were used to repair the beak of a red-crowned crane that had a complete fracture of the anterior maxillary bone and rhinotheca. The physical properties and stability of the prostheses and changes in the crane's behaviors after application of either beak were evaluated. The titanium alloy and PEEK prosthetic beaks weighed 30.81 g and 5.9 g, respectively. Scanning electron microscopy showed differences in microstructure between the 2 materials and the true beak; the true beak was softer than both materials from which the prostheses were made. The titanium beak frequently detached, and the residual natural beak showed significant cuticle softening with this prosthetic beak. The titanium beak detached within an approximately 3-month period after placement, whereas the PEEK prosthetic beak has remained secure for 2 years. Moreover, the crane's foraging times (P < .01) and grooming times (P < .05) with the titanium alloy false beak were lower than the normal, red-crowned crane. With the PEEK beak, no detachment or cuticle softening occurred, and foraging and grooming behaviors were evaluated by the investigators as natural (P > .05). Based on the results of this clinical case, the PEEK prosthetic beak was found to be superior to the titanium alloy prosthetic beak in color, weight, firmness, and postoperative effects.

Biological approaches for hypertrophic scars.

Scar formation is usually the pathological consequence of skin trauma. And hypertrophic scars (HSs) frequently occur in people after being injured deeply. HSs are unusually considered as the result of tissue contraction and excessive extracellular matrix component deposition. Myofibroblasts, as the effector cells, mainly differentiated from fibroblasts, play the crucial role in the pathophysiology of HSs. A number of growth factors, inflammatory cytokines involved in the process of HS occurrence. Currently, with in-depth exploration and clinical research of HSs, various creative and effective treatments budded. In here, we summarize the progress in the molecular mechanism of HSs, and review the available biotherapeutic methods for their pathophysiological characteristics. Additionally, we further prospected that the comprehensive therapy may be more suitable for HS treatment.